User:Drsimpalkothari/sandbox

Diabetes of pregnancy Gestational Diabetes (G D M) •	What is Gestational Diabetes Mellitus? Gestational Diabetes Mellitus (GDM) is a condition in which blood sugar levels rise above normal due to increased insulin needs and increased insulin resistance during pregnancy. •	Why is GDM important? The condition may pass unnoticed unless regular check-ups in pregnancy are carried out. The condition can lead to complications during pregnancy & childbirth. Women who have detected as GDM are 8 times more risk of developing diabetes in future. •	How do I know if I have GDM? A pregnant woman should register at antenatal clinic as soon as pregnancy is detected. ANC carries out test s for detection of GDM & other conditions.

•	How is the diagnosis made? Criteria for GDM as per Blood Sugar Levels Fasting			More than	 92 mg/dl 1 hour after meals	More than 	180mg/dl 2hour after meals	More than 	153 mg/dl

•	How do I treat gestational diabetes? The keystone to treatment of gestational diabetes is nutrition therapy. With your perinatal educator or dietitian, you will make a meal plan to meet your nutritional needs during pregnancy and to control your blood glucose level. Rather than three meals per day, you will be asked to eat smaller amounts of food more often. Certain foods, such as sweets, desserts and fruit juice, should be avoided. Monitoring your blood sugar before breakfast (fasting) and one hour/two hour after completion of each meal will guide you and your healthcare team in adjusting your meal plan until after the birth of your baby. (Self-monitoring of blood glucose) Blood glucose targets for diabetes:- Fasting	60-90  mg/dL Pre-meal	60-100 mg/dL 1 hour postprandial (after meal)	< 140 mg/dL 2 hours postprandial	< 120 mg/dL Some women are unable to meet these blood glucose targets despite their best efforts. In this case, the physician will recommend using medication to control blood glucose levels.

•	 Will GDM affect the course of my pregnancy? Most women who have Gestational Diabetes will deliver healthy babies. However, persistent high glucose levels may cause the baby to grow to a large size (greater than 4.5 KG) which can make delivery difficult. You will also be at an increased risk for infection and pre-eclampsia.

•	Will GDM affect my baby?

In most cases the problems your baby will experience will not be serious and will be easily treated. A small percentage of babies will need closer observation requiring admission to a special care nursery. These problems may include: 	Low blood sugar 	Low blood calcium and magnesium levels 	Excess red blood cells 	 Jaundice of the newborn 	Breathing problems 	Birth trauma

•	Will I have diabetes after the baby is born? After delivery, the blood sugar of a woman with GDM generally returns to normal (70-100 mg/dl fasting). The hormones responsible for insulin resistance in pregnancy are lost with delivery of the placenta. However, a woman who has had GDM is at greater risk for developing diabetes later in life. A healthy lifestyle including regular physical activity, proper food choices and maintaining a healthy body weight are important for reducing this risk. Your obstetrician may recommend that you see your primary physician for follow-up testing for 6months after delivery or, if breastfeeding, when your baby is weaned. •	Will the baby have diabetes? There is long-term risk that baby may develop impaired blood glucose tolerance & obesity in later life. Encourage breast feeding will reduce obesity, early lifestyle modification.

source- ADA guidelines